Newly Developed Sex-Specific Z Score Model for Coronary Artery Diameter in a Pediatric Population

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Abstract

Background

This study aimed to generate a Z score calculation model for coronary artery diameter of normal children and adolescents to be adopted as the standard calculation method with consensus in clinical practice.

Methods

This study was a retrospective, multicenter study that collected data from multiple institutions across South Korea. Data were analyzed to determine the model that best fit the relationship between the diameter of coronary arteries and independent demographic parameters. Linear, power, logarithmic, exponential, and square root polynomial models were tested for best fit.

Results

Data of 2,030 subjects were collected from 16 institutions. Separate calculation models for each sex were developed because the impact of demographic variables on the diameter of coronary arteries differs according to sex. The final model was the polynomial formula with an exponential relationship between the diameter of coronary arteries and body surface area using the DuBois formula.

Conclusion

A new coronary artery diameter Z score model was developed and is anticipated to be applicable in clinical practice. The new model will help establish a consensus-based Z score model.

Graphical Abstract

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Most cited references 23

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Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

Jane C. Burns, Elfriede Pahl, Tsutomu T. Saji … (2017)

Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries.

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Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements.

Brian McCrindle, Masato Takahashi, L. LuAnn Minich … (2007)

Most studies of coronary artery involvement and associated risk factors in Kawasaki disease have used the Japanese Ministry of Health dichotomous criteria. Analysis of serial normalized artery measurements may reveal a broader continuous spectrum of involvement and different risk factors. Clinical, laboratory, and echocardiographic measurements obtained at baseline and 1 week and 5 weeks after presentation were examined in 190 Kawasaki disease patients as part of a clinical trial of primary therapy with pulse steroids in addition to standard intravenous immunoglobulin. Maximum coronary artery z score normalized to body surface area was significantly greater than normal at all time points, decreasing significantly over time from baseline. A maximal z score > or = 2.5 at any time was noted in 26% of patients. Japanese Ministry of Health dimensional criteria were met by 23% of patients. Significant independent factors associated with greater z score at any time included younger patient age, longer interval from disease onset to treatment with intravenous immunoglobulin, lower serum IgM level at baseline, and lower minimum serum albumin level. z scores of the proximal right coronary artery were higher than those in the left anterior descending branch. Analyses of serial normalized coronary artery measurements in optimally treated Kawasaki disease patients demonstrated that for most patients, measurements are greatest at baseline and subsequently diminish; baseline measurements appear to be good predictors of involvement during early follow-up. When a more precise assessment is used, risk factors for coronary artery involvement are similar to those defined with arbitrary dichotomous criteria.

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Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults.

George B. Haycock, George J Schwartz, David H. Wisotsky (1978)

Estimates of body surface area were made based on measurement of 81 subjects, ranging from premature infants to adults. SA was calculated geometrically for each subject from 34 body measurements, and the values obtained compared with those based on previously published formulas and graphs. The most widely used formula, that of Du Bois and Du Bois, increasingly underestimated SA as values fell below 0.7 m2; the disparity was greatest in the newborn infant (7.96%). Closer agreement was obtained with the equations and nomograms of Body, Brody, Faber and Melcher, and Sendroy and Cecchini, although minor deviations were noted in some age ranges. The formula SA (m2) = weight (kg)0.5378 X height (cm)0.3964 X 0.024265, derived from the measured data by multiple regression analysis, gave a good fit for all values of SA from less than 0.2 m2 to greater than 2.0 m2 (r = 0.998). This formula was used to construct nomograms for estimation of SA in infants, children, and adults from height (length) and weight.

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Author and article information

Journal

Journal ID (nlm-ta): J Korean Med Sci

Journal ID (iso-abbrev): J Korean Med Sci

Journal ID (publisher-id): JKMS

Title: Journal of Korean Medical Science

Publisher: The Korean Academy of Medical Sciences

ISSN (Print): 1011-8934

ISSN (Electronic): 1598-6357

Publication date Collection: 29 April 2024

Publication date (Electronic): 16 April 2024

Volume: 39

Issue: 16

Electronic Location Identifier: e144

Affiliations

[1 ]Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea.

[2 ]Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea.

[3 ]Department of Pediatrics, Chonnam National University Medical School, Gwangju, Korea.

[4 ]Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

[5 ]Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea.

[6 ]Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea.

[7 ]Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.

[8 ]Department of Pediatrics, Institute of Medical Science, Gyeongsang National University College of Medicine, Gyeongsang National University Hospital, Jinju, Korea.

[9 ]Department of Pediatrics, Presbyterian Medical Center, Jeonju, Korea.

[10 ]Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, Korea.

[11 ]Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea.

[12 ]Department of Pediatrics, Ewha Womans University Medical Center, Seoul, Korea.

[13 ]Department of Pediatrics, Bundang Jesaeng General Hospital, Seongnam, Korea.

[14 ]Department of Pediatrics, Inje University Paik Hospital, Busan, Korea.

[15 ]Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Author notes

Address for Correspondence: Jeong Jin Yu, MD. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. jjyu@ 123456amc.seoul.kr

Author information

Jeong Jin Yu https://orcid.org/0000-0003-1601-3685

Hee Joung Choi https://orcid.org/0000-0002-7119-4194

Hwa Jin Cho https://orcid.org/0000-0002-2458-8529

Sung Hye Kim https://orcid.org/0000-0003-3608-0324

Eun Jung Cheon https://orcid.org/0000-0003-3844-0864

Gi Beom Kim https://orcid.org/0000-0002-7880-280X

Lucy Youngmin Eun https://orcid.org/0000-0002-4577-3168

Se Yong Jung https://orcid.org/0000-0003-1337-563X

Hyun Ok Jun https://orcid.org/0000-0003-2270-0123

Hyang-Ok Woo https://orcid.org/0000-0001-8849-9341

Sin-Ae Park https://orcid.org/0000-0002-7265-632X

Soyoung Yoon https://orcid.org/0000-0002-0705-5712

Hoon Ko https://orcid.org/0000-0002-5834-0900

Ji-Eun Ban https://orcid.org/0000-0002-7012-1786

Jong-Woon Choi https://orcid.org/0000-0002-5034-603X

Min Seob Song https://orcid.org/0000-0003-3426-6803

Ji Whan Han https://orcid.org/0000-0002-3024-0609

Article

DOI: 10.3346/jkms.2024.39.e144

PMC ID: 11058341

PubMed ID: 38685889

SO-VID: 83c87702-c1d2-4a7e-98b6-fc9709475656

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Newly Developed Sex-Specific Z Score Model for Coronary Artery Diameter in a Pediatric Population

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Abstract

Background

Methods

Results

Conclusion

Graphical Abstract

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Cardiovascular Innovations and Applications

Most cited references 23

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements.

Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults.

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